Ill-treatment and working the night shift increases nurse turnover

Workplace incivility, characterised by subtle forms of mistreatment (such as a dismissive gesture, raised voices or harsh words) can lead to lower job satisfaction, psychological stress, and a decline in physical health. These negative effects eventually result in higher employee turnover.

Workplaces where stress levels already run high are especially sensitive to incivility (because employees' emotional resources are highly taxed to begin with). And since high-stress environments tend also to be high-stakes, incivility could be at the heart of some very costly, even tragic mistakes.

This is particularly worrisome for organisations that have employees working in shifts, such as manufacturing firms, police departments and hospitals. Nowhere are the stakes higher than in hospitals with many countries facing nursing shortages. Retention has become an urgent issue. If incivility were to cause nurses to leave the profession, patients at the affected hospitals would bear the brunt.

Incivility is especially difficult to weed out of the workplace because it may be difficult for employees to even describe or articulate to Human Resources. But in his recent paper in the Journal of Vocational Behavior, Curtailing the harmful effects of workplace incivility: The role of structural demands and organization-provided resources, INSEAD Professor of Strategic Management, Quy Huy and his colleagues find that there are ways such incivility can be moderated.

"As the victims of incivility suffer, so will employee engagement and productivity, until managers intervene to help them cope. Fortunately, there are specific interventions that appear to do just that," said Huy.

In the study, the researchers performed a two-stage survey of 618 nurses at a 550-bed teaching and research hospital in the Southeastern United States. First, they asked the nurses to rate the hospital on measures of incivility, whether they worked overnight and whether they felt workplace expectations were unclear. Nurses were also asked about their exposure to managerial interventions known to mitigate stress and facilitate coping, such as team-building exercises and private informal meetings to discuss work responsibilities. Five months later, nurses were asked how likely they were to look for a new job in the coming year.

Huy and his colleagues had hypothesized that incivility's impact on employees depends on the presence of reinforcing stressors in the workplace environment, and on whether managers step in to help employees cope. Subjected to regression analysis, the survey results supported his hypothesis: Nurses who felt unclear about their workplace role and/or worked the night shift were far more likely to be eyeing the door, if they felt their surroundings were uncivil. Those who experienced interventions to aid coping had less desire to leave, regardless of perceived incivility.

Such interventions took the form of regular private meetings between the supervisor and employee to review tasks and team building interventions–focusing on both task-performance and feelings in the work place and home. Employees who participated in these meetings and team building sessions were less likely to have intentions of leaving.

"It's dangerously complacent to assume that everything's fine between your employees because you haven't heard otherwise. This could be the last straw that 'breaks the camel's back'. When in doubt, err on the side of being a little more concerned with employees' emotional well-being than strictly necessary," said Huy.

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